Treatment failure (annual failure rate) · Children with carious primary teeth treated by atraumatic restorative treatment (hand-instrument caries removal), no pulp therapy
ART restorations (mainly GIC) had a wide annual failure rate (1.2-37.1%) across 10 RCTs, with technique affecting survival; low to unclear quality of evidence (ungraded).
1 finding from 1 review
Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth
At 6 months, ART had significantly higher treatment success than placebo (OR 16.18).
1 finding from 1 review
OR 16.18 [1.21, 215.73]
44 studies
GRADE not reported
Discomfort associated with the procedure · People with dental caries in primary teeth (mainly children)
The reported estimate for discomfort with ART versus conventional treatment was inconclusive (ungraded).
1 finding from 1 review
Pain during the procedure (primary analysis) · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement
The reported estimate for procedural pain with ART versus conventional treatment was inconclusive (ungraded).
1 finding from 1 review
Oral health-related quality of life · Children with dental caries
ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).
3 findings from 1 review
Oral health-related quality of life · Children with dental caries
The network estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment and silver diamine fluoride.
2 findings from 1 review
New coronal caries in permanent first molars (caries prevention) · Children with dental caries in permanent (first) molars
ART within a brushing programme significantly reduced caries vs control (p<0.01; ungraded).
2 findings from 1 review
Mean new caries increment (surfaces) 0.01
1 study · 1016 participants
GRADE not reported
Mean new caries increment (surfaces) 0.06
1 study · 1016 participants
GRADE not reported
Restoration failure · Children (3-13 years) with dentine caries in primary teeth, no pulpal involvement
ART with GIC was reported to increase the odds of restoration failure versus conventional restoration (OR 1.60; ungraded).
1 finding from 1 review
Restoration survival · Children with decayed primary molar teeth
Multi-surface ART restorations had a reported survival rate of 73% at 1 year.
4 findings from 1 review
Survival rate 73
9 studies
GRADE not reported
Survival rate 95
9 studies
GRADE not reported
Survival rate 59
9 studies
GRADE not reported
Show 1 more finding
Survival rate 91
9 studies
GRADE not reported
Restoration survival · Children with occlusoproximal caries in primary teeth
The reported pooled ART success estimate was 1.04.
1 finding from 1 review
Oral health-related quality of life · Children with dental caries
The direct estimate found no statistically significant difference in oral health-related quality of life between atraumatic restorative treatment plus fluoride varnish and silver diamine fluoride plus fluoride varnish.
2 findings from 1 review
Restoration survival · Children with occlusoproximal caries in primary teeth
Multiple reviews reported similar restoration survival for ART versus conventional restorations in occlusoproximal cavities (ungraded).
1 finding from 1 review
Success or failure of restoration (as defined by the USPHS criteria) · Children with carious primary teeth
ART with high-viscosity GIC and amalgam had similar class I restoration success at 24 months (ungraded).
2 findings from 1 review
RR 1.07 [0.91, 1.27]
3 studies
GRADE not reported
RR 0.93 [0.83, 1.06]
3 studies
GRADE not reported
Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth
At 6 months, the Hall technique had significantly higher treatment success than ART (OR 10.11; moderate certainty).
3 findings from 1 review
OR 10.11 [3.03, 33.71]
44 studies
Moderate
OR 6.15 [2.55, 14.83]
43 studies
Moderate
OR 5.13 [1.18, 22.38]
21 studies
Moderate
Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth
At 12 months, conventional restorations had significantly higher treatment success than ART (OR 2.10; moderate certainty).
2 findings from 1 review
OR 2.10 [1.17, 3.78]
43 studies
Moderate
OR 2.67 [1.24, 6.15]
44 studies
Moderate
Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth
At 12 months, the Hall technique had significantly higher treatment success than SMART (OR 4.36; moderate certainty).
2 findings from 1 review
OR 4.36 [1.13, 16.77]
43 studies
Moderate
OR 5.61 [1.36, 23.08]
44 studies
Moderate
Patient discomfort during treatment (anxiety scale) · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars
One study found no significant difference in patient discomfort between SDF and ART (p = 0.15; ungraded).
1 finding from 1 review
Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
In one trial, SDF greatly increased individual-level caries arrestment versus ART/glass ionomer cement (OR 18.03); this subgroup was not separately GRADE-rated.
1 finding from 1 review
Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
Pooling two trials, SDF and ART/glass ionomer cement showed no clear difference in tooth-level caries arrestment (OR 1.22, wide CI; ungraded subgroup).
1 finding from 1 review
Caries/restoration status in permanent molars · Children with dental caries in permanent (first) molars
SDF gave significantly better caries/restoration outcomes than ART over 9 months in children's permanent molars (p=0.004; ungraded).
1 finding from 1 review
Satyarup et al. (2022): 38% SDF vs ART; SDF group 5.6% carious teeth with partly lost restorations vs ART 16.7% carious with partly lost and 8.9% carious with completely lost restorations (p=0.004, favoring SDF).
1 study · 190 participants
GRADE not reported